NPIMap

Organization Active NPI

Pocatello Cardiology Associates

  • Adult Health Clinical Nurse Specialist
  • Pocatello, ID
National Provider Identifier
1659540292
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
Legal business name
POCATELLO CARDIOLOGY ASSOCIATES
Practice address
777 Hospital Way BLDG a
Ste. 101
Pocatello, ID 83201-2753
Phone
(208) 234-2001
Fax
(208) 232-2195
NPI assigned
Feb 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephanie P Conoley
Title
Clinic Adminstrator
Phone
(208) 234-2001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SA2200X Primary

Addresses

Primary practice location

777 Hospital Way BLDG a
Ste. 101
Pocatello, ID 83201-2753

Mailing address

PO Box O
Pocatello, ID 83205-0049

Other identifiers 1

IdentifierTypeStateIssuer
806402400MedicaidID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1659540292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX O",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832050049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY BLDG A",
            "address_2": "STE. 101",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012753",
            "telephone_number": "208-234-2001",
            "fax_number": "208-232-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCATELLO CARDIOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "CONOLEY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CLINIC ADMINSTRATOR",
        "authorized_official_telephone_number": "208-234-2001"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806402400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.